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• W3098012353 abstract "Suggestions are statements that evoke an image in the listener’s mind. They may be positive, evoking an image of peace and hope or a desirable mood and behaviour, or they may be negative, eliciting thoughts of pain and doom. Once mentioned, the suggestion is front and centre: ‘You probably even didn’t think of an endotracheal tube before we mentioned it right now—even if we had instructed you not to do so or just reminded you that there is absolutely no need to think of it right now ’. When anaesthetists tell patients that a procedure such as intravenous or arterial line placement ‘will hurt’, the communication itself increases the likelihood of this possibility, and the perception referred to becomes more likely to be experienced as pain. Fortunately, suggestibility can also be used in a positive way — for example, telling patients that there are ways to improve their comfort such as coughing during IV cannulation or that breathing exercises after abdominal surgery can make things more comfortable. Also just not mentioning words with negative connotations significantly reduces pain and anxiety associated with potentially painful stimuli such as injection of local anaesthetic. Remaining factual ‘I will give you the local anaesthetic now’ or ‘the numbing medicine’ as some prefer, will suffice. In times of stress, patients assume a focus of attention that leads to a hypnotic frame of mind that is highly suggestible to communications from the anaesthetist, whether the communications are negative or positive. Hence an important step is to avoid wording with negative connotations. Often, however, even well-meaning comments are misunderstood. Many words have double meanings, and in this setting patients will cling to the more pessimistic interpretation. ‘I will put you to sleep’ may conjure images of the veterinarian euthanizing a pet. Also interpretations are highly individual. We (EL) had one patient who objected to being made ‘numb’ since ‘numb’ meant ‘dumb’ for him. The effects of suggestion become all too evident when considering the widely recognized phenomenon of placebo." @default.
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• W3098012353 date "2010-11-11" @default.
• W3098012353 modified "2023-10-14" @default.
• W3098012353 title "How words hurt" @default.
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